The effect of subjective perception of cognition on emotional functioning in adults with long-term neurological and neuropsychiatric disorders

Abstract

Purpose: To examine effects of subjective perception and objective status of cognition on emotional functioning in a sample of adults with long-term neurological and neuropsychiatric disorders.

Method: N = 65. Subjective measures were derived from the self-ratings on the Problem Checklist (PCL) from the HI-FI; the objective status was represented by combined externally standardised scores on neuropsychological tests across three cognitive domains: verbal memory, executive functioning, and psychomotor speed.

Results: No relationship was found between self-ratings of cognitive competence and performance on neuropsychological tests. Based on the results of the multiple regression analysis, approximately 40% of the variability in emotional functioning was explained by self-perceived cognitive and physical competence, while the addition of objective measures of cognition increased predictive capacity by only 1.3%. The awareness scores were calculated as the difference between objective performance scores and self-ratings of cognition. Overall, the sample demonstrated a tendency towards low awareness of cognitive deficits. Patients who overestimated cognitive deficits self-rated emotional functioning at a significantly lower level, while those with average or low awareness of deficits were equally emotionally content.

Conclusions: Self-perception of competence, rather than objective level of functioning influence emotional well-being and quality of life in individuals with long-term disabilities in our study.

IMPLICATIONS FOR REHABILITATION

• Cognitive deficits are common consequences of neurological dysfunction.

• This study shows that self-perception of cognitive competence, rather than objective level of cognitive functioning has critical influence on emotional well-being and perceived quality of life.

• An addition of psychotherapeutic intervention directed at alleviation of self-perception bias is likely to improve emotional well-being and enhance efficiency of rehabilitation efforts in patients with long-term disabilities due to neurological disorders.

• Based on our findings, patients with long-term disabilities could benefit from psychotherapy to improve their self-perception and quality of life.

Keywords:

• Neuropsychological assessment
• subjective report
• depression
• long-term outcome
• life satisfaction
• awareness of deficits

Acknowledgements

We thank Norma Vescovo, Jacqueline Marin-Sharp, Jackie Farrar at the Independent Living Center of Southern California, and Patricia Islikaplan for assistance with client referrals, data collection, and management. Special thanks to Alexander Mitrushina for assistance with statistical analyses.

Disclosure statement

No potential conflict of interest was reported by the authors.